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Critical care trials

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https://www.readbyqxmd.com/read/29237583/high-yield-hiv-testing-facilitated-linkage-to-care-and-prevention-for-female-youth-in-kenya-girls-study-implementation-science-protocol-for-a-priority-population
#1
Irene Inwani, Nok Chhun, Kawango Agot, Charles M Cleland, Jasmine Buttolph, Harsha Thirumurthy, Ann E Kurth
BACKGROUND: Sub-Saharan Africa is the region with the highest HIV burden. Adolescent girls and young women (AGYW) in the age range of 15 to 24 years are twice as likely as their male peers to be infected, making females in sub-Saharan Africa the most at-risk group for HIV infection. It is therefore critical to prioritize access to HIV testing, prevention, and treatment for this vulnerable population. OBJECTIVE: Using an implementation science framework, the purpose of this research protocol was to describe the approaches we propose to optimize engagement of AGYW in both the HIV prevention and care continuum and to determine the recruitment and testing strategies that identify the highest proportion of previously undiagnosed HIV infections...
December 13, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29237472/supply-kits-for-antenatal-and-childbirth-care-a-systematic-review
#2
REVIEW
Alicia Aleman, Giselle Tomasso, María Luisa Cafferata, Mercedes Colomar, Ana Pilar Betran
INTRODUCTION: It is critical to increase the uptake of interventions proven to be effective to improve maternal and perinatal outcomes. Supply kits have been suggested to be a feasible strategy designed to ensure timely availability and effective follow-up of care. OBJECTIVE: We conducted a systematic review to summarize the evidence on the uptake, effectiveness and safety of supply kits for maternal care. SEARCH STRATEGY: MEDLINE, the Cochrane Pregnancy and Childbirth Group's Trials Register, Campbell Collaboration, Lilacs, Embase and unpublished studies were searched...
December 13, 2017: Reproductive Health
https://www.readbyqxmd.com/read/29234503/study-protocol-for-a-phase-ii-dose-evaluation-randomized-controlled-trial-of-cholecalciferol-in-critically-ill-children-with-vitamin-d-deficiency-vitdal-picu-study
#3
Dayre McNally, Karin Amrein, Katharine O'Hearn, Dean Fergusson, Pavel Geier, Matt Henderson, Ali Khamessan, Margaret L Lawson, Lauralyn McIntyre, Stephanie Redpath, Hope A Weiler, Kusum Menon
Background: Clinical research has recently demonstrated that vitamin D deficiency (VDD) is highly prevalent in the pediatric intensive care unit (PICU) and associated with worse clinical course. Multiple adult ICU trials have suggested that optimization of vitamin D status through high-dose supplementation may reduce mortality and improve other clinically relevant outcomes; however, there have been no trials of rapid normalization in the PICU setting. The objective of this study is to evaluate the safety and efficacy of an enteral weight-based cholecalciferol loading dose regimen in critically ill children with VDD...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29233157/medical-student-intervention-to-promote-effective-nicotine-dependence-and-tobacco-healthcare-mind-the-gap-single-centre-feasibility-randomised-trial-results
#4
Anusha Kumar, Kenneth D Ward, Lisa Mellon, Miriam Gunning, Sinead Stynes, Anne Hickey, Ronán Conroy, Shane MacSweeney, David Horan, Liam Cormican, Seamus Sreenan, Frank Doyle
BACKGROUND: Although brief cessation advice from healthcare professionals increases quit rates, smokers typically do not get this advice during hospitalisation, possibly due to resource issues, lack of training and professionals' own attitudes to providing such counselling. Medical students are a potentially untapped resource who could deliver cessation counselling, while upskilling themselves and changing their own attitudes to delivering such advice in the future; however, no studies have investigated this...
December 11, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29232262/intermittent-versus-continuous-feeding-in-critically-ill-adults
#5
Jayshil J Patel, Martin D Rosenthal, Daren K Heyland
PURPOSE OF REVIEW: Early enteral nutrition is recommended in critically ill adult patients. The optimal method of administering enteral nutrition remains unknown. Continuous enteral nutrition administration in critically ill patients remains the most common practice worldwide; however, its practice has recently been called into question in favor of intermittent enteral nutrition administration, where volume is infused multiple times per day. This review will outline the key differences between continuous and intermittent enteral nutrition, describe the metabolic responses to continuous and intermittent enteral nutrition administration and outline recent studies comparing continuous with intermittent enteral nutrition administration on outcomes in critically ill adults...
December 11, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29229589/the-effect-of-group-support-psychotherapy-delivered-by-trained-lay-health-workers-for-depression-treatment-among-people-with-hiv-in-uganda-protocol-of-a-pragmatic-cluster-randomized-trial
#6
Etheldreda Nakimuli-Mpungu, Seggane Musisi, Kizito Wamala, James Okello, Sheila Ndyanabangi, Ramin Mojtabai, Jean Nachega, Ofir Harari, Edward Mills
BACKGROUND: There is limited information on the effectiveness of task shifting of mental health services in populations with HIV. OBJECTIVE: This trial aims to evaluate the effectiveness of group support psychotherapy delivered by trained lay health workers to persons living with HIV (PLWH) with depression in primary care. METHODS: Thirty eligible primary care health centers across three districts were randomly allocated to have their lay health workers trained to deliver group support psychotherapy (intervention arm) or group HIV education and treatment as usual (control arm) to PLWH with depression...
December 11, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29228144/randomized-controlled-trial-of-daily-text-messages-to-support-adherence-to-prep-in-at-risk-for-hiv-individuals-the-tapir-study
#7
David J Moore, Sonia Jain, Michael P Dubé, Eric S Daar, Xiaoying Sun, Jason Young, Katya Corado, Eric Ellorin, Joel Milam, Deborah Collins, Jill Blumenthal, Brookie M Best, Peter Anderson, Richard Haubrich, Sheldon R Morris
Background: Adherence is critical for efficacy of tenofovir disoproxil fumarate/emtricitabine as pre-exposure prophylaxis (PrEP). Methods: Between 02/2013 and 02/2016, 398 men who have sex with men and transgender women were randomized 1:1 to receive individualized Texting for Adherence Building (iTAB) or standard care (SoC) for 48 weeks. The primary endpoint was dried blood spot (DBS) tenofovir (TFV-DP) concentrations at both week 12 and week 48 (or the last on-drug visit) of >719 fmol/punch consistent with ≥4 doses per week (i...
November 24, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29227146/time-dependent-recovery-of-human-synovial-membrane-mesenchymal-stem-cell-function-after-high-dose-steroid-therapy-case-report-and-laboratory-study
#8
Yukihiko Yasui, David A Hart, Norihiko Sugita, Ryota Chijimatsu, Kota Koizumi, Wataru Ando, Yu Moriguchi, Kazunori Shimomura, Akira Myoui, Hideki Yoshikawa, Norimasa Nakamura
BACKGROUND: The use of mesenchymal stem cells from various tissue sources to repair injured tissues has been explored over the past decade in large preclinical models and is now moving into the clinic. PURPOSE: To report the case of a patient who exhibited compromised mesenchymal stem cell (MSC) function shortly after use of high-dose steroid to treat Bell's palsy, who recovered 7 weeks after therapy. STUDY DESIGN: Case report and controlled laboratory study...
December 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29225790/update-on-ventilator-associated-pneumonia
#9
REVIEW
Jean-Francois Timsit, Wafa Esaied, Mathilde Neuville, Lila Bouadma, Bruno Mourvllier
Ventilator-associated pneumonia (VAP) is the most frequent life-threatening nosocomial infection in intensive care units. The diagnostic is difficult because radiological and clinical signs are inaccurate and could be associated with various respiratory diseases. The concept of infection-related ventilator-associated complication has been proposed as a surrogate of VAP to be used as a benchmark indicator of quality of care. Indeed, bundles of prevention measures are effective in decreasing the VAP rate. In case of VAP suspicion, respiratory secretions must be collected for bacteriological secretions before any new antimicrobials...
2017: F1000Research
https://www.readbyqxmd.com/read/29223743/early-vs-late-tracheostomy-in-intensive-care-settings-impact-on-icu-and-hospital-costs
#10
Brent Herritt, Dipayan Chaudhuri, Kednapa Thavorn, Dalibor Kubelik, Kwadwo Kyeremanteng
INTRODUCTION: Up to 12% of the 800,000 patients who undergo mechanical ventilation in the United States every year require tracheostomies. A recent systematic review showed that early tracheostomy was associated with better outcomes: more ventilator-free days, shorter ICU stays, less sedation and reduced long-term mortality. However, the financial impact of early tracheostomies remain unknown. OBJECTIVES: To conduct a cost-analysis on the timing of tracheostomy in mechanically ventilated patients...
December 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29222705/tai-chi-and-qigong-for-cancer-related-symptoms-and-quality-of-life-a-systematic-review-and-meta-analysis
#11
REVIEW
Peter M Wayne, M S Lee, J Novakowski, K Osypiuk, J Ligibel, L E Carlson, R Song
PURPOSE: This study aims to summarize and critically evaluate the effects of Tai Chi and Qigong (TCQ) mind-body exercises on symptoms and quality of life (QOL) in cancer survivors. METHODS: A systematic search in four electronic databases targeted randomized and non-randomized clinical studies evaluating TCQ for fatigue, sleep difficulty, depression, pain, and QOL in cancer patients, published through August 2016. Meta-analysis was used to estimate effect sizes (ES, Hedges' g) and publication bias for randomized controlled trials (RCTs)...
December 8, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29222670/venetoclax-for-treating-chronic-lymphocytic-leukaemia-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#12
REVIEW
Hema Mistry, Chidozie Nduka, Martin Connock, Jill Colquitt, Theodoros Mantopoulos, Emma Loveman, Renata Walewska, James Mason
Venetoclax is licensed to treat relapsed or refractory (R/R) chronic lymphocytic leukaemia (CLL). As part of the Single Technology Appraisal (STA) ID944, the National Institute for Health and Care Excellence (NICE) invited AbbVie, the manufacturer, to submit evidence on the use of venetoclax, within its licensed indication. The Evidence Review Group (ERG), Warwick Evidence, was asked to provide an independent and critical review of the submitted evidence. Evidence came from three single-arm trials in CLL patients with or without 17p deletion [del(17p])/TP53 chromosomal abnormalities...
December 8, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/29221978/influence-of-6-hydroxyethyl-starch-130-0-4-versus-crystalloid-solution-on-structural-renal-damage-markers-after-coronary-artery-bypass-grafting-a-post-hoc-subgroup-analysis-of-a-prospective-trial
#13
Thomas Datzmann, Markus Hoenicka, Helmut Reinelt, Andreas Liebold, Hagen Gorki
OBJECTIVE: The restriction of hydroxyethyl starch (HES) has mandated changes in volume management based on data of critically ill patients. Reliable data of structural renal damage after HES treatment in cardiac surgical patients are lacking. The influence of 6% HES 130/0.4 was investigated in this study. DESIGN: An exploratory post hoc subgroup analysis of a prospective trial was performed. SETTING: The study was carried out at a university hospital...
May 25, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29220303/locally-aggressive-connective-tissue-tumors
#14
Mrinal M Gounder, David M Thomas, William D Tap
In this review, we highlight the complexities of the natural history, biology, and clinical management of three intermediate connective tissue tumors: desmoid tumor (DT) or aggressive fibromatosis, tenosynovial giant cell tumor (TGCT) or diffuse-type pigmented villonodular synovitis (dtPVNS), and giant cell tumor of bone (GCTB). Intermediate histologies include tumors of both soft tissue and bone origin and are locally aggressive and rarely metastatic. Some common aspects to these tumors are that they can be locally infiltrative and/or impinge on critical organs, which leads to disfigurement, pain, loss of function and mobility, neurovascular compromise, and occasionally life-threatening consequences, such as mesenteric, bowel, ureteral, and/or bladder obstruction...
December 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29219876/effectiveness-of-patient-centered-interventions-on-falls-in-the-acute-care-setting-compared-to-usual-care-a-systematic-review
#15
Donna Avanecean, Dawn Calliste, Teresita Contreras, Yeogyeong Lim, Aileen Fitzpatrick
BACKGROUND: Unintentional falls during hospitalization remain a concern for healthcare institutions globally despite implementation of various improvement strategies. Although the incidence of falls has been of heightened focus for many years and numerous studies have been done evaluating different approaches for fall prevention, fall rates remain high in acute care settings. Patient fall risk scales tend to address only particular intrinsic and extrinsic factors but do not adequately assess a patient's current fall risk status, subsequently warranting more patient-centered risk assessments and interventions...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29219875/ehealth-interventions-for-parents-in-neonatal-intensive-care-units-a-systematic-review
#16
Justine Dol, Alannah Delahunty-Pike, Sheren Anwar Siani, Marsha Campbell-Yeo
BACKGROUND: As technology becomes increasingly more advanced, particularly video technology and interactive learning platforms, some neonatal intensive care units are embracing electronic health (eHealth) technologies to enhance and expand their family-centered care environments. Despite the emergence of eHealth, there has been a lack of systematic evaluation of its effectiveness thus far. OBJECTIVES: To examine the effect of eHealth interventions used in neonatal intensive care units on parent-related and infant outcomes...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29218549/accuracy-and-reliability-of-a-subcutaneous-continuous-glucose-monitoring-device-in-critically-ill-patients
#17
S Rijkenberg, S C van Steen, J H DeVries, P H J van der Voort
Subcutaneous continuous glucose monitoring (CGM) may have benefits in achieving glycemic control in critically ill patients. The aim of this study was to assess the accuracy and reliability of the FreeStyle Navigator I in critically ill patients and to assess patient related factors influencing the accuracy and reliability. This study is a retrospective analysis of data from a randomized controlled trial conducted in a 20-bed mixed intensive care unit. Analytical accuracy, clinical accuracy and reliability were assessed against arterial blood glucose samples as reference...
December 7, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29212686/practice-patterns-in-the-care-of-acute-achilles-tendon-ruptures-is-there-an-association-with-level-i-evidence
#18
U Sheth, D Wasserstein, R Jenkinson, R Moineddin, H Kreder, S Jaglal
AIMS: To determine whether the findings from a landmark Canadian trial assessing the optimal management of acute rupture of the Achilles tendon influenced the practice patterns of orthopaedic surgeons in Ontario, Canada. MATERIALS AND METHODS: Health administrative databases were used to identify Ontario residents ≥ 18 years of age with an Achilles tendon rupture from April 2002 to March 2014. The rate of surgical repair (per 100 cases) was calculated for each calendar quarter...
December 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29212254/distinct-mobilization-of-leukocytes-and-hematopoietic-stem-cells-by-cxcr4-peptide-antagonist-ly2510924-and-monoclonal-antibody-ly2624587
#19
Sheng-Bin Peng, Robert D Van Horn, Tinggui Yin, Robin M Brown, William C Roell, Victor H Obungu, Charles Ruegg, Victor J Wroblewski, Eyas Raddad, John R Stille
Stromal cell-derived factor-1 (SDF-1) and its receptor CXCR4 play a critical role in mobilization and redistribution of immune cells and hematopoietic stem cells (HSCs). We evaluated effects of two CXCR4-targeting agents, peptide antagonist LY2510924 and monoclonal antibody LY2624587, on mobilizing HSCs and white blood cells (WBCs) in humans, monkeys, and mice. Biochemical analysis showed LY2510924 peptide blocked SDF-1/CXCR4 binding in all three species; LY2624587 antibody blocked binding in human and monkey, with minimal activity in mouse...
November 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/29211441/mechanistic-study-of-electrolyte-additives-to-stabilize-high-voltage-cathode-electrolyte-interface-in-lithium-ion-batteries
#20
Han Gao, Filippo Maglia, Peter Lamp, Khalil Amine, Zonghai Chen
Current developments of electrolyte additives to stabilize electrode-electrolyte interface in Lithium-ion batteries highly rely on a trial-and-error search, which involves repetitive testing and intensive amount of resources. The lack of understandings on the fundamental protection mechanisms of the additives significantly increases the difficulty for the transformational development of new additives. In this study, we investigated two types of individual protection routes to build a robust cathode-electrolyte interphase at high potentials: (i) a direct reduction in the catalytic decomposition of the electrolyte solvent; and (ii) formation of a "corrosion inhibitor film" that prevents severely attack and passivation from protons that generated from the solvent oxidation, even the decomposition of solvent cannot not mitigated...
December 6, 2017: ACS Applied Materials & Interfaces
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